Online Registration

First Name:
Last Name:
Gender:
Position: Goalkeeper     Forward     Midfielder     Defender 
Date of Birth:
Parent/Guardian Name:
Address:
City:
State:  Zip: 
Parent / Guardian E-Mail:
Home Phone Number: ( ) -
Club Team:
Emergency Contact Name:
Emergency Contact Number: ( ) -
Medically Fit for Camp:  
 
Please List Any Medical Concerns and/or Food Allergies:
 
*If your child has severe food allergies, please contact info@rutgerscamps.com immediately
 
Medical Insurance Coverage:  
Medical Group Plan Number:
 
 
Program Selection(s):Please check all appropriate boxes.
College ID Camp - Session One:  
January 7th - January 8th, 2017 / Fee: $150
College ID Camp - Session Two:  
March 18th - March 19th, 2017 / Fee: $150
Soccer Half-Day Hamilton Camp:  
Monday, June 26 - Friday June 30, 2017 9:00 AM - 12:00 PM / Fee $150
Soccer 1 Residential / Commuter Camp:   Overnight   Commuter
Sunday, July 9 - Wednesday July 12, 2017 / Overnight Fee $595 / Full Day Commuter Fee $430
Soccer 2 Residential / Commuter Camp:   Overnight   Commuter
Sunday, July 23 - Wednesday July 26, 2017 / Overnight Fee $595 / Full Day Commuter Fee $430
Evening Camp:
2017 Dates to be Announced
 
Comments, Notes and/or Special Requests:
 
 
Any problems or questions, please send an e-mail to info@rutgerscamps.com